Sickle cell disease: priapism was common.

Clinical bottom line (level 2c)

  1. A quarter of men with sickle cell disease, had priapism.
  2. Less than a tenth of men had an episode of priapism lasting more than 24 hours.
  3. Less than a tenth of men were hospitalised with priapism.
Fowler et al: Journal of Urology 1991; 145: 65-68
Expires June 2003

The study

Outcome study with objective outcomes, not adjusted for confounding factors, not validated in an independent set of patients.

Setting: sickle cell clinic, general hospital, USA

84 patients (aged range 12 to 74 years; mean 32, 100% male) sickle cell disease (n=65) or sickle cell trait (n=19)


100% followed for unknown
Outcomes studied:
  • priapism unwanted, sustained erection lasting 30 minutes or more
  • only one attack of priapism
  • priapism for >24 hours
  • hospitalised with priapism

    • The evidence

    outcome time to outcome number of patients/total number %
    (95% CI)
    priapism unknown 21/84 25.0%
    (15.7% to 34.3%)
    only one attack of priapism unknown 4/84 4.76%
    (0.21% to 9.32%)
    priapism for >24 hours unknown 6/84 7.14%
    (1.64% to 12.7%)
    hospitalised with priapism unknown 6/84 7.14%
    (1.64% to 12.7%)

    • Average age at onset of attack was 19 years (range 8 to 30 years).
    • The average number of attacks per year was between 1 and 52.
    • Of patients who had multiple attacks, the average duration of a typical episode was 1.6 hours; the longest self-limiting episode was 7.0 hours.
    • Four patients were treated with a shunting procedure, and of these two became impotent.

    Citation

    1. Fowler JE, Koshy M, Strub M, et al: Priapism associated with the sickle cell hemoglobinopathies: prevalence, natural history and sequale. Journal of Urology 1991; 145: 65-68
    Contributor: Clare Wotton and Musab Hayatli, June 2000
    Reviewer:

    Clinical Question.
    Patient sickle cell disease
    Intervention or Exposure prevalence
    Outcome priapism